Helen Carmenate, DDS

It's truly disappointing to hear that your experience with porcelain veneers has not met your expectations, especially with such an important event like your wedding approaching. Veneers should enhance your smile and feel natural, not cause discomfort or dissatisfaction. Given the issues you’ve described — gaps, poor gum aesthetics, and a bulky appearance — it would be wise to consider replacing them. In Miami, where you have access to numerous specialized cosmetic dental clinics, it’s crucial to seek out a provider with a strong track record in porcelain veneer placement. Look for a clinic that not only has extensive experience but also positive patient reviews, particularly concerning the aesthetics and comfort of their veneers. Before proceeding with such a significant investment, consult with a few well-regarded cosmetic dentists to discuss your concerns and see their previous work. This step will help ensure you achieve the beautiful, natural-looking results you desire for your wedding.

It's certainly unsettling to experience a veneer de-bonding, especially after an accidental impact like a sneeze. The immediate step is to visit your dentist to assess the damage and determine if the veneer can be re-bonded or if a new one is needed. Veneers generally have a robust attachment, but sudden impacts can compromise their bond. Considering you've had two sets of veneers with the first set lasting six years and the second set currently in use for two years, it sounds like they've generally been successful. One veneer de-bonding doesn't necessarily mean that your other veneers will fail, but it's a good idea to discuss with your dentist any preventative measures you can take to minimize further incidents, such as wearing a protective mouthguard during activities that might put your teeth at risk. Also, have your dentist check the integrity of your other veneers during your visit to ensure they are all secure.

If you're replacing an implant on your right front tooth and have a crown next to it, adding veneers to the top left teeth could indeed help create a more balanced and symmetrical appearance for your smile. Veneers are a great option for cosmetic improvements as they can adjust the color, shape, and alignment of your teeth with minimal invasiveness. It’s understandable that dental procedures can be stressful, but addressing each tooth individually to ensure overall harmony can significantly enhance both the aesthetics and functionality of your smile. It's a good idea to discuss this plan thoroughly with your dentist, who can provide a mock-up or digital simulation of how the veneers would look. This way, you can visualize the end result and feel more confident in your decision.

With severe bone loss in your upper front jaw, the feasibility of implants depends on the remaining bone density. You might need bone grafting to support implants in that specific area. If the bone loss is too significant, a full denture implant might be more effective. This solution uses multiple implants to support a denture, providing stability and preserving jawbone health. Consulting with a specialist is crucial to evaluate your specific needs and choose the best restoration method.

Raising the vertical dimension of your bite, especially after aligner treatment, requires careful consideration to ensure occlusal harmony and functional efficiency. At 38, if your anterior occlusion does not align well with your jaw size, adjusting the vertical dimension could indeed help improve both aesthetics and function. Crowns can be an effective solution to modify the vertical dimension of occlusion by building up the height of the teeth. When it comes to choosing a type of crown, you have several options depending on your specific needs for conservation and durability. Porcelain crowns are popular for their aesthetic appeal and good functional durability, matching the natural color of your teeth while providing the necessary strength for everyday use. If tooth conservation is a priority, consider minimally invasive options like onlays or 3/4 crowns, which cover less of the tooth but can still alter the height and shape effectively. Consulting with a prosthodontist or a dentist experienced in occlusal adjustments is crucial. They can assess your specific situation through detailed imaging and tests to recommend the best type of crown or alternative treatments that would suit your dental structure and functional requirements